Mother to Child HIV Prevention – how it works

A step-by-step explanation of how the government’s programme to prevent mother to child transmission of HIV works, from ante-natal HIV testing to birth and beyond.

Every pregnant woman attending ante-natal clinics at the pilot sites takes part in group counselling about HIV/AIDS and the Nevirapine programme.

All women are then offered an HIV test. Every woman who accepts the test gets individual counselling of 20 ‘ 30 minutes before the test. Trained counsellors give further information about HIV/AIDS transmission, how the test works, how Nevirapine works and feeding options for babies to prevent HIV transmission. A woman who wants to join the programme signs a consent form.

She then takes the Abbott test. One of her fingers is pricked with a sterile needle and the blood is transferred on to a special piece of paper. If the line on the paper turns red, she is HIV positive. If the test is positive, a second test ‘ called a Smart test ‘ is taken to confirm the result. If the results are discordant (one positive and one negative), another blood test is taken, called an Elisa test, and these results are sent to a laboratory.

Discordant results are very unusual. Usually, the test is straightforward and results are ready within 15 minutes. She goes back to a counsellor to get the results in private.

If the woman is HIV positive, she is encouraged to live healthily and to use condoms to prevent further infection. She is also encouraged to come to the hospital or clinic as soon as she goes into labour. However, from 28 weeks pregnant, she is given a Nevirapine tablet to take home with her in case she doesn’t reach the hospital or clinic before giving birth.

She is also counselled about how to feed her baby once it is born. HIV can be transmitted via breast milk, so women with access to clean running water and proper sanitation are given the option of a six-month free supply of formula milk. Women without access to water and sanitation are encouraged to breastfeed exclusively (not even to give water) for six months. They are not encouraged to use formula as it would be difficult for them to keep the bottles and water germ-free, so their babies would be at great risk of getting gastro-intestinal infections.

Once an HIV positive woman goes into labour, she takes her Nevirapine tablet. Nurses are discouraged from artificially rupturing her membranes or giving her an episiotmy (cutting her vagina to facilitate the baby’s birth) as these practices expose the baby to more body fluids and blood.

Her baby is given a spoonful of Nevirapine syrup.

She is once again counselled about safe feeding. She brings her baby back to be checked once a month. These babies are followed up for 18 months.

From six weeks, babies are given vitamins and prophylactic drugs to guard against common opportunistic infections. At some sites, the mothers are also given these.